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Plain films of the lumbar spine (not provided) were unremarkable.
A diagnosis of herniated disk was made, and the patient was treated with strict bed rest and pelvic traction for several weeks. He was then put into a back brace and showed continued improvement.
Herniated disks are rare in prepubertal children, but are increasing in incidence in adolescents as more and more undertake competitive sports. It occurs after an exertion and is traumatic in nature, unlike herniated disks in adults which are degenerative in nature. Herniated disks in adolescents are larger than those in adults because adolescents have a small tear in a health annulus, causing a large amount of disk tissue to extrude. Plain films of the spine are unremarkable. A MRI exam will show an asymmetric extradural defect on the thecal sac.
Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
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